By Romy Ellenbogen, Miami Herald
TALLAHASSEE, Fla. — In Florida, you can’t turn away a patient on the basis of their race, color, sex, religion or national origin. But a doctor can turn someone away if they’re unvaccinated.
Gov. Ron DeSantis and Surgeon General Joseph Ladapo want to end that. In a news conference earlier this month, where they discussed a plan to make Florida the only state in the nation without any vaccine mandates, DeSantis said pediatricians should not deny care to children because they don’t have certain vaccinations.
“That’s wrong, and it’s coercive,” DeSantis said. “It tries to undercut your ability to choose.”
Two years ago, DeSantis and the Legislature were adamant about giving doctors the freedom to run their practice as they please. In 2023, the governor signed a bill allowing physicians the ability to deny any patient a treatment if it violates their conscience or morals.
At a news conference where he signed that bill, inspired by the COVID-19 pandemic, DeSantis said he wanted to ensure doctors could “follow the data, not dictates.”
Doctors in South Florida who deny unvaccinated patients point to vaccines as a life-saving measure they intend to stick to.
Marimón Pediatrics, an office in Miami, notes in its vaccination policy that it respects a parent’s right as a decision maker, but adds: “as medical professionals who are scientists, we also know that vaccines save lives.”
Another office in Miami says that “if you have chosen not to vaccinate your child, Pediatric Professional Associates is not the right practice for you.”
And Pedroso Pediatrics in Hollywood uses a sample vaccine policy from the group Immunize.org, which says “the vaccine campaign is truly a victim of its own success” and says parents who choose to not vaccinate are “taking selfish advantage of thousands of others.”
Public health experts credit vaccines with saving the lives of young children and nearly eradicating certain diseases in the United States.
The immunizations in question are for school-aged children, protecting against infections and diseases like tetanus, polio, measles and whooping cough. Since 1971, Florida has required those vaccines for kids to attend school, public or private.
Parents can exempt their kids from the required shots if they have a medical or religious reason. As vaccine skepticism has grown since the pandemic, vaccine rates have dropped.
Last school year, 88% of Florida kindergartners were up to date on vaccinations, a decrease from 94% in 2019, according to the Florida Department of Health.
Dr. Joel Rudman, a family doctor and the former House representative who sponsored the medical conscience law, said he understands where the governor and surgeon general are coming from — but said he didn’t think a proposal requiring doctors to see certain patients would work.
“I would hate to think a doctor is seeing me just because the government made them see me,” he said.
Rudman, in his own practice, sees children whose parents don’t want to vaccinate them or who are skeptical about vaccines. Rudman said choosing to turn patients away because they decline to take a certain action goes against his training.
And while he said he thinks it’s wrong for doctors to deny care to unvaccinated patients, he said forcing their hand may violate the medical conscience bill he pushed for.
Traditionally, whether to see an unvaccinated patient has been at a doctor’s discretion. The American Medical Association advises doctors that a patient’s vaccination status isn’t a sufficient reason to turn a patient away.
The American Academy of Pediatrics guidance tells doctors that dismissing patients can be acceptable when “less drastic alternatives are not feasible.”
Dr. Rana Alissa, the president of the Florida Chapter of the American Academy of Pediatrics, said seeing unvaccinated patients requires special precautions and could risk staff and other patients being exposed, including children too young to have received some of the recommended shots.
Alissa said physicians aren’t choosing to take fewer sick kids or choosing to take only certain ages of children. Instead, she said, they’re putting their foot down about a public health matter.
“If you’re going to take the public health safety from our community and our state and our neighborhood, at least let me maintain it in my own clinic,” Alissa said.
Last session, DeSantis and Ladapo pushed to amend the patients’ bill of rights, a section of state law meant to help with communication between health care providers and patients.
They wanted to say that “a health care provider or health care facility may not discriminate against a patient based solely upon the patient’s vaccination status.”
That language was ultimately stripped from the bill in end-of-session haggling.
Ladapo at the time said he often heard from people who were having trouble finding a pediatrician if they deviated from the U.S. Centers for Disease Control and Prevention’s recommended vaccine schedule.
Ladapo, who lives in Pinellas County, said he knows that “most” doctors there won’t entertain deviations in the schedule. He said he is sympathetic to parents who choose to do so and who are then turned away by pediatricians.
It’s not yet clear if the Department of Health will renew the push for language requiring doctors to see unvaccinated patients. A Department of Health spokesperson said bill proposals for the 2026 legislative session are being workshopped.
If the department does try to insert the same language in the patients’ bill of rights, it may not bind doctors in the way lawmakers intend.
A House bill analysis from earlier this year noted that “violations of the rights enumerated in the Patient’s Bill of Rights and Responsibilities are not independently enforceable” and said the bill can’t be used in any civil or administrative action.
Alissa said she anticipates the bill being submitted and said she and the Florida Chapter of the American Academy of Pediatrics would fight it.
“Why should a politician tell me who should I see and who should I not see?” Alissa said.
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